标准化管理在小儿人工气道护理中的应用研究
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摘要
目的:探讨使用标准化管理方案在儿童呼吸机人工气道护理中的应用效果。方法:选取标准化管理前2016年10月～2017年3月的180例机械通气患儿为对照组,实施标准化管理后选取2017年10月～2018年3月的138例机械通气患儿为试验组。比较两组患儿呼吸机相关性肺炎的发生率、非计划拔管率、机械通气时间和住院时间。结果:与对照组相比,试验组在机械通气48h后,呼吸机相关性肺炎的发生率和非计划拔管率更低,机械通气时间及住院时间更短,差异均有统计学意义(均P<0.05)。结论:小儿人工气道的标准化管理可明显减少呼吸机相关性肺炎的发生率和非计划性拔管率,有效降低机械通气时间和住院时间。
Objective:To explore the effect of standardized management on pediatric artificial airway care.Methods:A total of 180 cases in October 2016 to March 2017 with ventilation before standardized management were selected as the control group.Another 138 cases in October 2017 to March 2018 with ventilation after application of standardized management were chosen in the experimental group.The incidence of ventilator-associated pneumonia(VAP),unplanned extubation rate,mechanical ventilation time and hospital stays were analyzed.Results:Compared to the control group,the incidence of VAP,unplanned extubation rate,mechanical ventilation time and hospital stays were obviously reduced in the experimental group,all with significant difference(All P<0.05).Conclusion:The standardized management applied to pediatric artificial airway care could reduce the incidence of VAP and unplanned extubation rate obviously,decrease the time of mechanical ventilation and hospital stays effectively.
Objective:To explore the effect of standardized management on pediatric artificial airway care.Methods:A total of 180 cases in October 2016 to March 2017 with ventilation before standardized management were selected as the control group.Another 138 cases in October 2017 to March 2018 with ventilation after application of standardized management were chosen in the experimental group.The incidence of ventilator-associated pneumonia(VAP),unplanned extubation rate,mechanical ventilation time and hospital stays were analyzed.Results:Compared to the control group,the incidence of VAP,unplanned extubation rate,mechanical ventilation time and hospital stays were obviously reduced in the experimental group,all with significant difference(All P<0.05).Conclusion:The standardized management applied to pediatric artificial airway care could reduce the incidence of VAP and unplanned extubation rate obviously,decrease the time of mechanical ventilation and hospital stays effectively.
引文
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[6]中华人民共和国卫生部.多重耐药菌医院感染预防与控制技术指南(试行)[J].中国危重病急救医学,2011,23(2):65.
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[9]alvarez-Lerma F,Palomar-Martínez M,Sanchez-García M,et al.Prevention of ventilator-associated pneumonia:the multimodal approach of the Spanish ICU“pneumonia zero”program[J].Crit Care Med,2018,46(2):181-188.
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[2]中华医学会重症医学分会.呼吸机相关性肺炎诊断、预防和治疗指南(2013)[J].中华内科杂志,2013,52(6):524-543.
[3]单君,顾艳荭,吴娟,等.有效吸痰预防呼吸机相关性肺炎的研究进展[J].中华护理杂志,2011,46(1):98-100.
[4]冯冬梅,陈鹏,李利,等.人工气道内吸痰深度的研究进展[J].中国护理管理,2016,16(1):111-116.
[5]李金芳,邵芹,王正梅,等.两种气囊压力监测方法预防呼吸机相关性肺炎的效果比较[J].中华现代护理杂志,2012,18(30):3697-3698.
[6]中华人民共和国卫生部.多重耐药菌医院感染预防与控制技术指南(试行)[J].中国危重病急救医学,2011,23(2):65.
[7]梁振明,朱亚非,朱银燕,等.新生儿呼吸机相关性肺炎的危险因素分析[J].中华医院感染学杂志,2015,25(1):232-234.
[8]Hu X,Zhang Y,Cao Y,et al.Prevention of neonatal unplanned extubations in the neonatal intensive care unit:a best practice implementation project[J].JBI Database System Rev Implement Rep,2017,15(11):2789-2798.
[9]alvarez-Lerma F,Palomar-Martínez M,Sanchez-García M,et al.Prevention of ventilator-associated pneumonia:the multimodal approach of the Spanish ICU“pneumonia zero”program[J].Crit Care Med,2018,46(2):181-188.
[10]Rose L,Schultz M J,Cardwell C R,et al.Automated versus non-automated weaning for reducing the duration of mechanical ventilation for critically ill adults and children[J].Cochrane Database Syst Rev,2014,10(6):CD009235.